Corona Virus/COVID19: Local Impact

[Hecaviator]

https://covid19.healthdata.org/projections

Projections updated...

Projected total deaths down to 80k. And it also predicts a much sooner end to the outbreak.

I truly hope the lower projections you cite pan out, but caution might be advised for several reasons:

1. The epidemiological models I've been able to find and read about on line are based on assumptions of preemptive and mitigation measures that may or may not be applied or maintained. It is hard to factor in the uncertainties evident in the current climate where there is no centralized (federal) management of such measures in the USA. It is still pretty much the Wild West in terms of policies and practices.

2. Models use data. Beware of garbage in - garbage out. The reporting of confirmed cases and deaths by the various states and local governments in the USA is probably better than much of the data coming in from around the world. (There are a lot of questions to be raised about the reporting and data from other parts of the world. Some of it just doesn't make sense.) There is likely to be some garbage involved in the data here in the USA. At this point, it's just a question of how much and how quickly it can be weeded out.

3. Testing in the USA has been an abysmal failure so far. Contact tracing, and sustained follow up beyond initial tracing, isn't any better in most states. For that matter, with a few exceptions like Germany and New Zealand, testing and derivative measures like contact tracing in other parts of the world hasn't been very good either. That has a direct bearing on the problem of garbage in - garbage out when modeling. Even the experts don't have a clear idea what they are dealing with, as admitted by Dr. Fauci. I think the word he used is "struggling". We used to call this situation WBG - we be guessin'. Not a pretty thought when you consider the situation we're in. Like I noted previously, you can't manage what you can't measure.

4. What data is being widely reported (e.g., the John Hopkins U. reporting), appears to be based solely on "confirmed" infections and deaths. It is reported by various sources. That may inject another wildcard into the modeling, the reliability of those sources. We don't know what quality control is being applied to the data sources. It also ignores the 800 lb gorilla in the room: there doesn't seem to be anything credible regarding the extent of unconfirmed cases. Given that some unknown portion of those persons infected are asymptomatic (and therefore aren't getting tested), but are capable of passing on the virus to others without knowing it, you have a hidden component of the overall infection rate. That will likely sustain the spread of the virus to some unknown degree. That is totally speculative, but could potentially increase the peak and lengthen the curve. It basically blinds the modeling, i.e., unless someone has figured out what the unconfirmed incidence of infections is with some reliability, the model has a blind spot. That hidden portion of the total extent of infection is coupled with the testing debacle, and won't get resolved until testing can be statistically reconciled to account for both confirmed and unconfirmed infections. That can only be done by testing in numerous geographical regions, not one or two. You wouldn't want to model based only on Wyoming or only on New York City. Trying to apply tailored modeling to all of the states individually (or to local areas) without statistical accounting of the "unconfirmed" incidence of infection is a big ask. Maybe that uncertainty is fully reflected in the broad ranges shown in the modeling. Maybe not.

5. Treatment via a new vaccine or use of other drugs is uncertain and very speculative in terms of timing and effectiveness. Any reliable and properly validated vaccine is probably not just over the horizon, which is why none of the models I've seen account for it in any way. I suppose we can hope for a miracle, though that would seem to be intruding on the space already preempted by the federal government.

IMO, this has been a total cluster up to this point and seems likely to continue for a while. All we can really do is be kind to each other and hang on. And at least do what Drs. Fauci and Birx suggest.

 

[DataDude]

I truly hope the lower projections you cite pan out, but caution might be advised for several reasons:

1. The epidemiological models I've been able to find and read about on line are based on assumptions of preemptive and mitigation measures that may or may not be applied or maintained. It is hard to factor in the uncertainties evident in the current climate where there is no centralized (federal) management of such measures in the USA. It is still pretty much the Wild West in terms of policies and practices.

2. Models use data. Beware of garbage in - garbage out. The reporting of confirmed cases and deaths by the various states and local governments in the USA is probably better than much of the data coming in from around the world. (There are a lot of questions to be raised about the reporting and data from other parts of the world. Some of it just doesn't make sense.) There is likely to be some garbage involved in the data here in the USA. At this point, it's just a question of how much and how quickly it can be weeded out.

3. Testing in the USA has been an abysmal failure so far. Contact tracing, and sustained follow up beyond initial tracing, isn't any better in most states. For that matter, with a few exceptions like Germany and New Zealand, testing and derivative measures like contact tracing in other parts of the world hasn't been very good either. That has a direct bearing on the problem of garbage in - garbage out when modeling. Even the experts don't have a clear idea what they are dealing with, as admitted by Dr. Fauci. I think the word he used is "struggling". We used to call this situation WBG - we be guessin'. Not a pretty thought when you consider the situation we're in. Like I noted previously, you can't manage what you can't measure.

4. What data is being widely reported (e.g., the John Hopkins U. reporting), appears to be based solely on "confirmed" infections and deaths. It is reported by various sources. That may inject another wildcard into the modeling, the reliability of those sources. We don't know what quality control is being applied to the data sources. It also ignores the 800 lb gorilla in the room: there doesn't seem to be anything credible regarding the extent of unconfirmed cases. Given that some unknown portion of those persons infected are asymptomatic (and therefore aren't getting tested), but are capable of passing on the virus to others without knowing it, you have a hidden component of the overall infection rate. That will likely sustain the spread of the virus to some unknown degree. That is totally speculative, but could potentially increase the peak and lengthen the curve. It basically blinds the modeling, i.e., unless someone has figured out what the unconfirmed incidence of infections is with some reliability, the model has a blind spot. That hidden portion of the total extent of infection is coupled with the testing debacle, and won't get resolved until testing can be statistically reconciled to account for both confirmed and unconfirmed infections. That can only be done by testing in numerous geographical regions, not one or two. You wouldn't want to model based only on Wyoming or only on New York City. Trying to apply tailored modeling to all of the states individually (or to local areas) without statistical accounting of the "unconfirmed" incidence of infection is a big ask. Maybe that uncertainty is fully reflected in the broad ranges shown in the modeling. Maybe not.

5. Treatment via a new vaccine or use of other drugs is uncertain and very speculative in terms of timing and effectiveness. Any reliable and properly validated vaccine is probably not just over the horizon, which is why none of the models I've seen account for it in any way. I suppose we can hope for a miracle, though that would seem to be intruding on the space already preempted by the federal government.

IMO, this has been a total cluster up to this point and seems likely to continue for a while. All we can really do is be kind to each other and hang on. And at least do what Drs. Fauci and Birx suggest.

I agree wholeheartedly. I am an actuary and have been desperate for some data that I could look at and say this would be really good information for decision making and there is next to none out there. On March 17th in another forum I floated the idea of the United States putting everyone on lockdown and doing a 100,000 person random testing and then following those folks for 14 days to see how things went testing them in the middle and again at the end. I felt the dat gained would be invaluable in decision making. I was told the tests were needed for sick people. To me though if you're sick they are treating the symptoms not the disease right now so there isn't really a need to confirm you have it. That was 3 weeks ago now and we are 4 weeks from decision on what to do on May 1 at a federal level. I bet a lot of people would like to have the results of a study like that right now.

 

[e1iterate]

The media may not tell you this, but if you use a little common sense to interpret the factual data you will find something positive. According to John Hopkins University data, the daily percentage of increase for new COVID-19 cases in the U.S. is trending down. This means we will soon reach the peak (when it gets to 0%) and that is when the curve becomes flat.

👑🦠 Coronavirus Tracker: Charts, graphs, and maps of COVID-19 infections, recoveries, and deaths.

Coronavirus/COVID-19 metrics tracking tool with charts supporting multi-country aggregation, regression analysis, and a map with absolute and relative figures on a sliding scale for historical adjustment.

coronavirus.arik.io

 

[Otis32]

Given the shortage of tests and inconsistencies in how the testing was applied from state to state it seems like tracking hospitalizations for Covid 19 instead of positive cases would be more informative.

In several states where that info is published daily (and one can track it) it sure appears like some of the early numbers that were being thrown out during the roll out of the "Stay at Home" orders may prove to be exaggerated. Having said that there is some troubling trends showing up in parts of the south.....

Am I in the minority when I say that much more $$, resources & time should be thrown at developing a therapeutic right now vs. a vaccine?

 

[Stryker]

I played a quick 9 with my son yesterday and the course was really busy. It was not my home course but I know they were really busy too. This got me thinking, I have noticed in the last couple weeks that with more people not working the courses seem to be busier then usual. I wonder if the courses in states where they have remained open are actually doing better and thriving more this year then in the past because more people are not working and looking to get outside however they can. I would really like to see some numbers on this after all this is over. I am also wondering will it cause an uptick in the number of people playing golf that were not before after it is over in those states. It would be an interesting case study for sure.

 

[DataDude]

Given the shortage of tests and inconsistencies in how the testing was applied from state to state it seems like tracking hospitalizations for Covid 19 instead of positive cases would be more informative.

In several states where that info is published daily (and one can track it) it sure appears like some of the early numbers that were being thrown out during the roll out of the "Stay at Home" orders may prove to be exaggerated. Having said that there is some troubling trends showing up in parts of the south.....

Am I in the minority when I say that much more $$, resources & time should be thrown at developing a therapeutic right now vs. a vaccine?

I think they should have started mid March with a nationwide 100,000 person random testing. Then tested those 100,000 people a week later and again 14 days later. They also would have had those people answer maybe 10 or 11 questions about how they feel and do a temperature reading. That data would have been massively helpful in decision making for public officials. On the medical front I doubt the people working on a vaccine overlap with the people working on medication so I am not sure going all in one way or the other would be very helpful. It might be like making a construction worker do my job or making me go work construction. Neither of us would be much help and we might be a hinderance.

 

[Danimal]

I agree wholeheartedly. I am an actuary and have been desperate for some data that I could look at and say this would be really good information for decision making and there is next to none out there. On March 17th in another forum I floated the idea of the United States putting everyone on lockdown and doing a 100,000 person random testing and then following those folks for 14 days to see how things went testing them in the middle and again at the end. I felt the dat gained would be invaluable in decision making. I was told the tests were needed for sick people. To me though if you're sick they are treating the symptoms not the disease right now so there isn't really a need to confirm you have it. That was 3 weeks ago now and we are 4 weeks from decision on what to do on May 1 at a federal level. I bet a lot of people would like to have the results of a study like that right now.

I have always questioned these models because of the amount of people that haven’t been tested. In Missouri we have a total of ~2500 cases. But even people with symptoms can’t be tested. I ha a friend who was showing definite symptoms, they tested him for the flu and he was negative. He asked for a Covid- 19 test but he was under 50 without any underlying conditions. How many unreported positives do we have out there? Must be 5-10 times what is being reported.

 

[M2Giles]

I think they should have started mid March with a nationwide 100,000 person random testing. Then tested those 100,000 people a week later and again 14 days later. They also would have had those people answer maybe 10 or 11 questions about how they feel and do a temperature reading. That data would have been massively helpful in decision making for public officials. On the medical front I doubt the people working on a vaccine overlap with the people working on medication so I am not sure going all in one way or the other would be very helpful. It might be like making a construction worker do my job or making me go work construction. Neither of us would be much help and we might be a hinderance.

Here in Georgia there is a less than 15% positive rate for testing. Considering they have been limited to people showing symptoms and are have another reason to reasonably believe they have been infected (travel or interaction with known positive) I would of expected this number to be higher.

They also wont test a lot of people if risk factors aren't there.

I think it's highly infectious, but at the same time the data is all over the place right now.

 

[DataDude]

I have always questioned these models because of the amount of people that haven’t been tested. In Missouri we have a total of ~2500 cases. But even people with symptoms can’t be tested. I ha a friend who was showing definite symptoms, they tested him for the flu and he was negative. He asked for a Covid- 19 test but he was under 50 without any underlying conditions. How many unreported positives do we have out there? Must be 5-10 times what is being reported.

Around 10x confirmed is a good guess based on the number of asymptomatic that has been seen in places with some wider testing IMO.

 

[Golf Ghost]

Canada with some decent news over the weekend. Not a huge deal, but maybe the beginning of something. Previously we were doubling every 2.5-3 days, now we're in the 3-3.5 day range.

 

[Gyro25]

Not local as in geography, but local in family. My grandmother's family in Greece is just being torn apart. Her best friend and her son and his family, another cousin, and another cousin are all in their 90s with symptoms and very unlikely to make it. My grandma is just an emotional wreck, and can only try and comfort her over the phone

 

[Reframmellator]

The concerns expressed here about data are why I have been focusing on hospitalization and death data. Those numbers aren't subject to test availability, although hospitalization data become invalid should we run out of beds. The last time I checked - and I haven't checked in a few days - we were beginning to blunt those curves. I would prefer a well-designed testing study for the population at large, but that appears unlikely

 

[Reframmellator]

Not local as in geography, but local in family. My grandmother's family in Greece is just being torn apart. Her best friend and her son and his family, another cousin, and another cousin are all in their 90s with symptoms and very unlikely to make it. My grandma is just an emotional wreck, and can only try and comfort her over the phone

I can't imagine how awful that is for all of you.

 

[JDax]

I truly hope the lower projections you cite pan out, but caution might be advised for several reasons:

1. The epidemiological models I've been able to find and read about on line are based on assumptions of preemptive and mitigation measures that may or may not be applied or maintained. It is hard to factor in the uncertainties evident in the current climate where there is no centralized (federal) management of such measures in the USA. It is still pretty much the Wild West in terms of policies and practices.

2. Models use data. Beware of garbage in - garbage out. The reporting of confirmed cases and deaths by the various states and local governments in the USA is probably better than much of the data coming in from around the world. (There are a lot of questions to be raised about the reporting and data from other parts of the world. Some of it just doesn't make sense.) There is likely to be some garbage involved in the data here in the USA. At this point, it's just a question of how much and how quickly it can be weeded out.

3. Testing in the USA has been an abysmal failure so far. Contact tracing, and sustained follow up beyond initial tracing, isn't any better in most states. For that matter, with a few exceptions like Germany and New Zealand, testing and derivative measures like contact tracing in other parts of the world hasn't been very good either. That has a direct bearing on the problem of garbage in - garbage out when modeling. Even the experts don't have a clear idea what they are dealing with, as admitted by Dr. Fauci. I think the word he used is "struggling". We used to call this situation WBG - we be guessin'. Not a pretty thought when you consider the situation we're in. Like I noted previously, you can't manage what you can't measure.

4. What data is being widely reported (e.g., the John Hopkins U. reporting), appears to be based solely on "confirmed" infections and deaths. It is reported by various sources. That may inject another wildcard into the modeling, the reliability of those sources. We don't know what quality control is being applied to the data sources. It also ignores the 800 lb gorilla in the room: there doesn't seem to be anything credible regarding the extent of unconfirmed cases. Given that some unknown portion of those persons infected are asymptomatic (and therefore aren't getting tested), but are capable of passing on the virus to others without knowing it, you have a hidden component of the overall infection rate. That will likely sustain the spread of the virus to some unknown degree. That is totally speculative, but could potentially increase the peak and lengthen the curve. It basically blinds the modeling, i.e., unless someone has figured out what the unconfirmed incidence of infections is with some reliability, the model has a blind spot. That hidden portion of the total extent of infection is coupled with the testing debacle, and won't get resolved until testing can be statistically reconciled to account for both confirmed and unconfirmed infections. That can only be done by testing in numerous geographical regions, not one or two. You wouldn't want to model based only on Wyoming or only on New York City. Trying to apply tailored modeling to all of the states individually (or to local areas) without statistical accounting of the "unconfirmed" incidence of infection is a big ask. Maybe that uncertainty is fully reflected in the broad ranges shown in the modeling. Maybe not.

5. Treatment via a new vaccine or use of other drugs is uncertain and very speculative in terms of timing and effectiveness. Any reliable and properly validated vaccine is probably not just over the horizon, which is why none of the models I've seen account for it in any way. I suppose we can hope for a miracle, though that would seem to be intruding on the space already preempted by the federal government.

IMO, this has been a total cluster up to this point and seems likely to continue for a while. All we can really do is be kind to each other and hang on. And at least do what Drs. Fauci and Birx suggest.

You obviously haven’t read any of my posts on the model, I’ve been pointing out the fallacy of the model the whole time.

 

[Phil75070]

I went to the course for my regular weekday tee time with the same two other guys I've played with for years. A single shows up and the course wanted to pair him up with us. I declined and when they pushed I said then I could not play. I am in a high risk group other than just because of my age. With my two regulars I know, if, when and where they have traveled, how they are about social distancing, the precautions they take and I know and trust them enough to know if they had the slightest symptoms they would not be there. I know zilch about a stranger. Am I wrong to push back on having a stranger play along with us?

 

[Reframmellator]

I went to the course for my regular weekday tee time with the same two other guys I've played with for years. A single shows up and the course wanted to pair him up with us. I declined and when they pushed I said then I could not play. I am in a high risk group other than just because of my age. With my two regulars I know, if, when and where they have traveled, how they are about social distancing, the precautions they take and I know and trust them enough to know if they had the slightest symptoms they would not be there. I know zilch about a stranger. Am I wrong to push back on having a stranger play along with us?

Not by me. I'm over 60, in generally good health, and I was offered a chance by the pro shop to round out a foursome. I declined, and I think the threesome was probably relieved as well.

 

[M2Giles]

Work just published that face coverings are now required and that medical ppe will not be provided while on property. While I wont be headed in for awhile, I think that says a lot right now.

Glad I ordered those Seamus Masks.

Note for those that say something that we have to be provided ppe if they mandate it my profession has a lot of things for OSHA not applying and they have already issued me a gas mask before all of this....

 

[th6252]

I went to the course for my regular weekday tee time with the same two other guys I've played with for years. A single shows up and the course wanted to pair him up with us. I declined and when they pushed I said then I could not play. I am in a high risk group other than just because of my age. With my two regulars I know, if, when and where they have traveled, how they are about social distancing, the precautions they take and I know and trust them enough to know if they had the slightest symptoms they would not be there. I know zilch about a stranger. Am I wrong to push back on having a stranger play along with us?

During this crisis, yes I don’t blame you for the push back and I think you did right by yourself(and for any family you may live with).
In the future, maybe you can call the course ahead and maybe try to ask them to make an exception for you due to being in a high risk group?

 

[Danimal]

I went to the course for my regular weekday tee time with the same two other guys I've played with for years. A single shows up and the course wanted to pair him up with us. I declined and when they pushed I said then I could not play. I am in a high risk group other than just because of my age. With my two regulars I know, if, when and where they have traveled, how they are about social distancing, the precautions they take and I know and trust them enough to know if they had the slightest symptoms they would not be there. I know zilch about a stranger. Am I wrong to push back on having a stranger play along with us?

Nope. I will only play as a single walking. No offense to others, but I am trying to eliminate variables.

 

[M2Giles]

I went to the course for my regular weekday tee time with the same two other guys I've played with for years. A single shows up and the course wanted to pair him up with us. I declined and when they pushed I said then I could not play. I am in a high risk group other than just because of my age. With my two regulars I know, if, when and where they have traveled, how they are about social distancing, the precautions they take and I know and trust them enough to know if they had the slightest symptoms they would not be there. I know zilch about a stranger. Am I wrong to push back on having a stranger play along with us?

Honestly even playing with the regular group would be a stretch for me.

If we are all walking then maybe.

 

[JDax]

The concerns expressed here about data are why I have been fociuusing on hospitalization and death data. Those numbers aren't subject to test availability, although hospitalization data become invalid should we run out of beds. The last time I checked - and I haven't checked in a few days - we were beginning to blunt those curves. I would prefer a well-designed testing study for the population at large, but that appears unlikely

This we have a winner...

 

[JDax]

Serious question:

My wife has taken Hydroxycloroquine for Lupus, with little to no side effects. If a COVID19 patient is critical, it would be common sense to try it and see if it helps them w/o causing additional harm?

The drug has been around for 50 years, so we have a lot of studies on this drug.

I’m trying to understand uproar....

 

[tahoebum]

I agree just offering loans (most of which will need to be repaid) isn’t a good option if this shut down passes April into May or longer.

As well as agree on the best option of paying interest on loans, triple net on rental, while having some utilities forgiveness as a way to give many small business owners the opportunity to try and keep there business afloat and develop demand again. However, not being political, someone is going to have to force those entities into offering those options. Currently, after speaking to multiple people in those areas they have no interest in asking for nothing less than normal payments. Of my three locations, only one landlord offered to hold off a portion of one month rent (still paying triple net) for one month only. All bank I am involved with said they are not offering any changes and suggested any business that has issues look at reducing overhead and at borrowing options.

We will see if things from lenders and landlords changes if this shut down last longer. Better to get something versus having multiple vacancies and credit issues when businesses close and don’t pay debt back.

A lot of the loans don’t have to be paid back. My buddy owns a small business with a partner and they employ 10 or 11 others. He just applied for a $150,000 loan and if it is used for payroll and he doesn’t lay anyone off, only the interest on the loan has to be back, the $150k will be forgiven.

 

[JB]

A lot of the loans don’t have to be paid back. My buddy owns a small business with a partner and they employ 10 or 11 others. He just applied for a $150,000 loan and if it is used for payroll and he doesn’t lay anyone off, only the interest on the loan has to be back, the $150k will be forgiven.

I was under the impression the forgiveness and payroll is only for 10 weeks and its not a guarantee it is forgiven as you have to apply for forgiveness.
And its still unknown (to me) if there is an officer carve out on this as well.

 

[radiman]

Serious question:

My wife has taken Hydroxycloroquine for Lupus, with little to no side effects. If a COVID19 patient is critical, it would be common sense to try it and see if it helps them w/o causing additional harm?

The drug has been around for 50 years, so we have a lot of studies on this drug.

I’m trying to understand uproar....

I have seen a lot of hubbub surrounding this creating a shortage for Lupus patients. Now, I don't know much about Lupus. So, I have a question since I don't quite understand. If your wife was unable to get this medication for a month or more, what side effects would she have? Is it life threatening? Or, more of a comfort issue? Not trying to say anything one way or another. Just trying to understand more why some people are pissed that this is being used for Covid-19 as it makes it harder for Lupus patients to get it.